Question Downgrade policy for respiratory panel 0202U

marianak

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I am not able to find downgrade policy for respiratory panel 0202U. This code is denied by some insurances as not covered under the contract. But the other panel 0241U is covered. 0241U includes all 4 targets that is part of 0202U. Is it ok to resubmit denied 0202U by correcting it to 0241U

Also i wonder for insurances that deny both 0202U and 0241U can i resubmit claims by correcting the PLA codes to a single covid testing cpt code 87635 ? Covid test is included in both panels, basically by downgrading i bill insurance just one target of the whole panel that was run to at least get a payment.

Downgrading policies are so hard to find on commercials and HMO insurance. CMS has no information on that as well. I would appreciate any suggestion.
 
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